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Abstract
Rooney RM, Cramer EH, Mantha S, Nichols G, Bartram JK, Farber JM,
Benembarek PK. "A review of outbreaks of foodborne disease associated
with passenger ships: evidence for risk management," Public Health
Report, 2004, 119:4
(July-August), 427-34.
Foodborne disease outbreaks
on ships are of concern
because
of their potentially serious health consequences for passengers and
crew and high costs to the industry. The authors conducted a review of
outbreaks of foodborne diseases associated with passenger ships in the
framework of a World Health Organization project on setting guidelines
for ship sanitation. The authors reviewed data on 50 outbreaks of
foodborne disease associated with passenger ships. For each outbreak,
data on pathogens/toxins, type of ship, factors contributing to
outbreaks, mortality and morbidity, and food vehicles were collected.
The findings of this review show that the majority of reported
outbreaks were associated with cruise ships and that almost 10,000
people were affected. Salmonella spp were most frequently associated
with outbreaks. Foodborne outbreaks due to enterotoxigenic E. coli spp,
Shigella spp, noroviruses (formally called Norwalk-like viruses),
Vibrio spp, Staphylococcus aureus, Clostridium perfringens, Cyclospora
sp, and Trichinella sp also occurred on ships. Factors associated with
the outbreaks reviewed include inadequate temperature control, infected
food handlers, contaminated raw ingredients, cross-contamination,
inadequate heat treatment, and onshore excursions. Seafood was the most
common food vehicle implicated in outbreaks. Many ship-associated
outbreaks could have been prevented if measures had been taken to
ensure adequate temperature control, avoidance of cross-contamination,
reliable food sources, adequate heat treatment, and exclusion of
infected food handlers from work.
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